The biggest controversy in breast augmentation surgery is whether the implant should be placed above (subglandular placement) or below (submuscular placement) the pectoralis major muscle. Particular placements tend to work best with certain types of implants and incision / insertion techniques. What is interesting is that although doctors practice both procedures almost equally (60/40 in favor of subglandular placement), some doctors are adamant about one or the other, and often demonize doctors who choose the other option. The adamant proponents of subglandular placement criticize the submusculars for cutting open the pectoralis major muscle and claim that the period of settling which submuscular placement requires is actually the process of complete atrophying in the muscle. They also point out that submuscular placement is barbaric in that it causes undue pain for the patient.
On the other hand, doctors who favor submuscular placement say that the larger implants used by subglandular doctors give women a cheap and artificial appearance. They also say that subglandular placement of breast implants unnecessarily risks women’s lives by interfering with mammograms. And they point to an increased risk of capsular contracture for subglandular placement, although this charge, say subglandular doctors, is strictly untrue and downright insulting.
It is unlikely this controversy will be resolved, but it is one of the most important questions to have answered before going ahead with your breast enhancement surgery. One thing that is beyond controversy, however, is that either placement depends for its success on a doctor that is comfortable and experienced with the procedure.
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